Provider Demographics
NPI:1427280445
Name:HOOVER, MARK SCOTT (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:SCOTT
Last Name:HOOVER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 S WABASH AVE
Mailing Address - Street 2:UNIT 501
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2335
Mailing Address - Country:US
Mailing Address - Phone:847-452-2849
Mailing Address - Fax:
Practice Address - Street 1:141 W JACKSON BLVD
Practice Address - Street 2:SUITE A 20
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604-2929
Practice Address - Country:US
Practice Address - Phone:847-452-2849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011435111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor